AB0320 ASSOCIATION OF THE BIOMARKERS SOLUBLE ST2, GALECTIN-3, N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE, PENTRAXIN WITH MYOCARDIAL DYSFUNCTION DETECTED BY SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS PRIOR TO BIOLOGICAL THERAPY
Authors: I. Kirillova, T. Popkova, Y. Gorbunova, M. Diatroptov
Journal: Annals of the Rheumatic Diseases (2022)

Background Risk of developing cardiovascular complications and death in rheumatoid arthritis (RA) is 50% higher than in the total population. The biomarkers soluble ST2 (sST2), galectin-3, pentraxin and N-terminal pro-brain natriuretic peptide (NT-proBNP) provide prognostic information in pts with heart failure. Objectives To determine the frequency of myocardial dysfunction (lower global longitudinal epicardial strain of left ventrical (GLES LV) using echocardiographic method of speckle tracking, the level of NT-proBNP, pentraxin, galectin-3 and sST2 in patients (pts) with RA prior to therapy with bDMARDs. Methods A total of 41 pts with RA (ACR/EULAR criteria, 2010) were included in the study: 63% of women, age 56 [37;66] years, disease duration 24 [8;96] months; DAS28 6,01 [5.3;6.3], positive for ACCP (92%), RF (78%), without cardiovascular diseases and prior administration of bDMARDs. All pts underwent echocardiography, tissue Doppler imaging and the speckle tracking assessment of GLES LV. 44% of RA pts received methotrexate (median dose - 15 (15;20) mg / week.), 35% - leflunomide, 9.3% - sulfasalazine, 7% - hydroxychloroquine, 67.4% - glucocorticoids (median dose - 5 (4;8) mg / day.), 74% - nonsteroidal anti-inflammatory drugs. In each RA pts, we measured plasma concentrations of sST2 (Cristal Diagnostics, San Diego), galectin-3 (Bender MedSystems GmbH Biocenter, Vienna Austria) NT-proBNP (Roche Diagnostics, Switzerland) and pentraxin (Hycult Biotech, Netherland). The control group consisted of 10 healthy subjects, which were matched by sex and age. Results : In pts with RA speckle-tracking method detected lower global longitudinal epicardial strain (GLES)(–16.5 [-14.6; -18.5]%), compared to the healthy control group (–21.58 [-22.1;-20.4] %, p=0.0001). 27(67%) RA pts showed a decrease GLES. RA pts also had higher levels of NT-proBNP (114.8 [45.1; 277.5] pg/ml vs 52 [40.5; 69.1] pg/ml, p&lt;0.05), lower levels of sST2 (10.6 [9.2; 13.1] ng/ml vs 13.5 [11.0; 19.7] ng/ml, p&lt;0.04) compared to control group. All RA pts were divided into 2 groups: group 1- with low GLES, group 2 - with preserved GLES. In group 1, the levels of ST2 were significantly lower than in group 2 (Table 1). There were no differences in left ventricular ejection fraction, LV sizes, LV myocardial mass index, NT-proBNP, pentraxin, galectin-3 levels between groups. Table 1. Levels of biomarkers in groups low GLES, (n=27) Normal GLES, (n=14) p sST2, ng/ml 13.2 [10.6;17.0] 18.3 [13.7;60.9] &lt;0.05 Pentraxin, ng/ml 0.29 [0.05;0.42] 0.3 [0.02;0.79] &gt;0.05 galectin-3, ng/ml 4.0 [2.6;6.9] 4.3 [3.2;5.3] &gt;0.05 NT-proBNP, pg/ml 105 [42;260] 94 [35.5;378.8] &gt;0.05 There were negative correlations between the global longitudinal epicardial strain and age (r=-0,9, p&lt;0,02), E velocity LV (r=-0,5, p&lt;0,04), sST2 (r=-0,5, p&lt;0,02). Galectin-3 correlates with left atrial volume (r=0,4, p&lt;0,04), septal e’ velocity (r=0,6, p&lt;0,008). ST2 levels correlate with ESR (r=0,6, p&lt;0,04), CRP (r=0,5, p&lt;0,002). Conclusion In pts with RA frequently (67%) were detected lower global longitudinal epicardial strain, higher levels of NT-proBNP and lower levels of sST2. In RA pts the sST2 biomarker is better associated with inflammatory activity and myocardial dysfunction. Disclosure of Interests None declared